Call to action

The World Health Organization (WHO), working with Alzheimer's Disease International, released the first-ever global report on dementia last month. It warned that the number of people living with dementia worldwide is likely to triple by 2050.

Since more than 70 percent of these cases will be in developing countries, the agencies are urging nations to face up to this looming problem by strengthening their public health systems now.

Old doesn't mean demented

A WHO video on the web presents a montage of elderly people throughout the world engaged in activities that would exhaust a younger person. Particularly impressive is the image of a 100-year old man finishing a marathon.

Martin Prince, who is Professor of Epidemiological Psychiatry at King's College London, told DW that all of the systems in the body begin to degenerate to some extent as one grows older.

"From the age of 25 onwards, the number of functioning neurons - or brain cells - in our brain reduces gradually, and there are some changes in our mental performance," Prince said.

But dementia is a brain illness, Prince explained. Of brain illnesses causing dementia, Alzheimer's disease is the most common. It accounts for nearly 70 percent of the people with dementia. Brains affected by Alzheimer's disease are completely different from normally aging brains, he said.

"Actually, the majority of centenarians do not suffer from dementia," Prince added.

In other words, if you live to be 100, you probably will retain most or all of your mental faculties.

Dementia affects people throughout the world, with more than half living in low-and middle-income countries. By 2050, WHO predicts incidences of dementia will increase from nearly 36 million to more than 115 million.

And that's a huge problem, because health systems, particularly in poorer countries, are not prepared to deal with larger numbers of older people in need of a lot of help.

Preventable risk factors

Dementia is a brain disorder, usually chronic in nature. It's caused by a variety of brain illnesses that affect memory, thinking and the ability to perform everyday activities.

Vascular dementia, one of the most common forms of dementia after Alzheimer's, is caused by problems with the supply of blood to the brain.

Shekhar Saxena, director of the WHO's mental health and substance abuse program, said that unlike Alzheimer's - for which there is no cure - vascular dementia can be prevented.

Addressing the risk factors - including diabetes, hypertension, obesity, smoking and physical inactivity - can prevent the onset of vascular dementia, he said.

And he points out that treatment for dementia is frequently delayed because the symptoms are not always recognized.

"It's commonly mistaken for an age-related decline in functioning," Saxena said, because it can mimic age-related problems and progresses slowly.

Even in high-income countries, only one-fifth to one-half of the cases of dementia are routinely recognized. This percentage is obviously much lower in middle and low-income countries.

Growing problem in developing countries

Dementia is not yet a huge problem in developing countries, because few people live to be older than 75 years, when dementia usually begins to exhibit.

This is expected to change with population growth and improved health. The problem is likely to overwhelm nations in Africa, and will become particularly acute in Asia - where the majority of the world's population lives.

The WHO reports that more than $600 billion a year is spent treating and caring for people with dementia, and that this figure is expected to rise, leading some health officials to calling dementia a ticking time bomb.

Yet so far, only a handful of countries have strategies in place to deal with the disease.

Prince says there's a huge lack of awareness of the problem in developing countries. Many governments assume that the extended family will care for their relatives in the future as they have in the past, he said.

But the organization's research indicates that's unlikely to be the case, due to societal changes. Increasing numbers of people don't have children or extended family available, for example, to provide care, financial support and accommodation.

Immigration to urban centers is another factor breaking up traditional family structures.

"People migrate to other cities or out of the country in order to seek work - with increased education of women, women are less available and less willing perhaps to provide care," Prince added.

Call to action

Marc Wortmann, the executive director of Alzheimer's Disease International, describes the statistics as frightening.

There's a new case of dementia in the world every four seconds now, Wortmann pointed out, while only 10 years ago, this was calculated at one in every seven seconds.

"So if you look into the future projections, it may be close to one every second by the year 2050," Wortmann said. He sees this as a wake-up call.

The report urges nations to set up programs that focus on improving early diagnosis and raising public awareness about the disease. It recommends caregivers get involved in support programs for people with dementia and others affected.

It says community-based services can provide valuable support to families caring for people with dementia in both high- and low-income countries. And this will delay the need for people to enter into high-cost residential care, the report adds.

There is no cure for dementia, but health officials say a great deal can be done to support and improve the lives of those afflicted with the disease, along with their families and caregivers.

"We need to act, we need to do something to stop this epidemic," Wortmann asserted.

Author: Lisa Schlein, Geneva / sad
Editor: Sarah Steffen